NPI | 1770787087 |
---|---|
Entity Type | Organization |
Authorized Contact | WANDA DITTHARDT Office Manager 954-964-4113 |
Organization Subpart ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: FL ME62894) |
Additional Taxonomies | 174400000X Specialist (Licence: FL ME64761) |
Enumeration Date | 2007-06-12 |
Last Update Date | 2020-08-22 |